Periprosthetic osteolysis after AES total ankle replacement: Conventional radiography versus CT-scan. Issue 3 (September 2015)

• Record Type: Journal Article
• Authors: Viste, Anthony; AL Zahrani, Nader; Brito, Nuno; Lienhart, Christophe; Fessy, Michel Henri; Besse, Jean-Luc
• Is Part Of: Foot and ankle surgery. Volume 21:Issue 3(2015:Sep.)
• Page Start: 164
• Page End: 170
• Publication Date: 2015-09
• Subjects: Foot -- Surgery -- Periodicals; Ankle -- Surgery -- Periodicals; Ankle -- surgery -- Periodicals; Foot -- surgery -- Periodicals; Ankle -- Surgery; Foot -- Surgery; Periodicals; Electronic journals; 617.58
• DOI: 10.1016/j.fas.2014.11.002
• Languages: English
• ISSNs: 1268-7731

Abstract

<abstract abstract-type="author" id="abs0005"> <title id="sect0005">Abstract</title> <sec> <title id="sect0015">Background</title> <p id="spar0500">The aim of this study was to compare conventional X-rays and CT-scan in detecting peri-prosthetic osteolytic lesions, a major concern after total ankle replacement (TAR).</p> </sec> <sec> <title id="sect0020">Methods</title> <p id="spar0600">We prospectively assessed 50 patients (mean age 56 years), consecutively operated on by the same senior surgeon, between 2003 and 2006 and with a mean follow-up period of 4 years (range, 2–6.2). The component used was AES<sup>®</sup> total ankle replacement. The etiologies for total ankle arthroplasty were: posttraumatic in 50%, osteoarthritis secondary to instability in 36%. Plain radiographs were analyzed by 4 independent observers, using a 10-zone protocol (location) and 5 size categories.</p> </sec> <sec> <title id="sect0025">Results</title> <p id="spar0700">At 4-year follow-up, all patients had been CT-scan assessed with the same protocol by 2 independent observers. Plain radiographs showed dramatic progression of severe periprosthetic lyses (>10 mm): from 14% to 36% of interface cysts for the tibial component respectively at 2 and 4-year follow-up and from 4% to 30% for the talar implant. The talar component was more accurately assessed by CT-scan (mean frontal and sagittal talar lesion: from 270 mm<sup>2</sup> to 288 mm<sup>2</sup> for CT-scan versus 133 mm<sup>2</sup> to 174 mm<sup>2</sup> for X-rays). For tibial cysts, axial views showed larger lesions (313 mm<sup>2</sup>) than frontal (194 mm<sup>2</sup>) or sagittal (213.5 mm<sup>2</sup>) views. At 4-year follow-up, 24% of patients had revision with curetage or arthrodesis, and at 7 years follow-up 38% were revised.</p> </sec> <sec> <title id="sect0030">Conclusion</title> <p id="spar0800">These results are similar to recent AES series, justifying withdrawal of this device. CT-scan was more accurate than X-rays for detecting and quantifying periprosthetic osteolysis. We recommend a yearly radiological control and CT-scan in case of lesion on X-rays.</p> </sec> </abstract>